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Biomedical subjects

L E Graham

Publications and source records attributed to L E Graham.

At least 37 records · Page 2Linked to original sources

Speech characteristics and behavior-type assessment in the Multiple Risk Factor Intervention Trial (MRFIT) structured interviews.

Four speech characteristics (SCs) were scored from 626 audiotaped Structured Interviews (SIs) designed to assess behavior type in the Multiple Risk Factor Intervention Trial (MRFIT). Analyses suggested that interviewers relied upon respondents' voice emphasis, speed of speaking, speed of answering, and answer content (in that order) for behavior typing. Across the clinics, there were large differences in the degree that each interviewer and auditor used these SCs for behavior-type judgments, and these differences appear to be related to differences in interauditor reliability. Correlations between the various SCs were very low, suggesting that key operationally defined characteristics of Type A behavior occurred independently in the SI. Analysis of interviewers' SCs indicated that they spoke and asked questions more quickly of Type A than Type B subjects--suggesting that interviewers' behaviors were biased by respondents' behavior type. Overall, the findings indicate the complexity of the behavior-type judgment process and how the criteria for assessment may change depending upon interviewer or population differences.

Adult↗

Consequences of worksite hypertension screening. Changes in absenteeism.

To confirm reports of increased absenteeism after worksite hypertension screening, we performed a three-stage blood pressure screening among 5888 self-selected heterogeneous workers at 11 electronics plants using standardized screening and labeling procedures. A total of 296 subjects with mean systolic blood pressure of 140 mm Hg or greater or diastolic blood pressure of 90 mm Hg or greater on all three occasions were considered to have sustained hypertension. From the untreated normotensive subjects matched for eight sociodemographic and occupational variables, we prospectively selected one to three controls for each sustained hypertensive subject. Uncorrected absenteeism rates for sustained hypertensive subjects increased 22% from baseline in the postscreening year. Correction by logarithmic transformation for skewed distributions and by rates for matched controls for temporal trends reduced these changes to statistical insignificance with high statistical power. Several subgroups exhibited trends to increased absenteeism. At 12-month follow-up, the blood pressure of the sustained hypertensive subjects showed mean decreases of 12.6/6.7 mm Hg (p less than 0.0001) after the majority had received pharmacological antihypertensive treatment. These results suggest that worksite hypertension screening and labeling produce insignificant absenteeism change overall among self-selected heterogeneous work force populations.

Absenteeism↗

Consequences of worksite hypertension screening. Differential changes in psychosocial function.

To evaluate reports of psychosocial dysfunction after worksite screening, a three-stage blood pressure screening was performed using standardized screening and labeling procedures. Of a heterogeneous group of 5,888 workers, 296 with sustained hypertension were identified and randomly assigned to traditional arousal or reassurance debriefings, matching each hypertensive subject with one to three normotensive control subjects on eight sociodemographic and occupational variables. Subjects exhibiting absenteeism increases or persistent hypertension six months after screening were randomly assigned to worksite health education programs or no intervention. After adjustment for values among matched control subjects, previously unaware hypertensive subjects had significant post-screening decreases in anxiety that were significantly associated with specific worksites and with reassurance rather than traditional debriefing (p less than 0.05). The health education program did not significantly affect anxiety, blood pressure, or absenteeism. Increased absenteeism was associated with higher baseline anxiety levels (p less than 0.05). It is concluded that worksite hypertension screening produces minimal adverse psychosocial changes, reassurance debriefing may be beneficial, and unspecified worksite characteristics may determine consequences of similar preventive medicine efforts.

Absenteeism↗

Teleconferencing.

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Education, Medical, Continuing↗

Setting generality of blood pressure reductions and the psychological treatment of reactive hypertension.

The setting generality of treatment effects was examined for a client with 3 years' history of essential hypertension. Self-control progressive relaxation training led to durable normotensive blood pressures (BP) in the natural environment and psychology clinic, although medical setting BP remained elevated. Further assessment indicated that this latter problem was a function of conditioned anxiety to medical setting stimuli. Systematic desensitization led to reductions in medical setting BP to normotensive levels, and laboratory psychophysiological assessments confirmed the elimination of the anxiety response. The present case study raises the issue of to what extent such reactive hypertension is a problem for other individuals similarly diagnosed and demonstrates the importance of the assessment of generality of treatment effects for essential hypertension.

Adult↗